Diabetic Ketoacidosis With Acute Necrotizing Pancreatitis as First Presentation in Latent Autoimmune Diabetes in Adult

Abstract

This case describes delayed diagnosis of acute necrotizing pancreatitis in the setting of diabetic ketoacidosis (DKA) as the first presentation of late onset autoimmune diabetes of adulthood (LADA). Possible presentation of DKA with LADA and acute pancreatitis (AP) are explored in this paper, with an emphasis on early diagnosis of pancreatitis for appropriate management. This case is a critical reminder that although DKA can non-specifically elevate pancreatic enzymes, LADA and AP can present concurrently, and pancreatic pathology should still be considered in the differential.

A Rare Triad: Hypercalcemia-Induced Necrotizing Pancreatitis Presenting as Severe Diabetic Ketoacidosis

“…Elevation of serum lipase and amylase may also be a nonspecific occurrence in 24.7% to 79.0% of patients with DKA. 7 However, this case highlights the benefits of ordering serum lipase and amylase early in patients with DKA, and a possible need for including these tests in standardized management guidelines. In patients being managed for AP, the presence of other comorbidities including DKA can further raise mortality to as high as 80%.…”